GMC v Tripathi: High Court quashes GP's suspension over sexual misconduct but declines to order erasure

The High Court has quashed a Medical Practitioners Tribunal's decision to suspend a general practitioner found to have sexually assaulted a patient, holding that the panel's reasoning on sanction was marred by serious irregularities. It stopped short, however, of substituting erasure, remitting the question instead to a freshly constituted tribunal.

In General Medical Council v Tripathi [2026] EWHC 1653 (Admin), Jonathan Richards, sitting as a deputy High Court judge, allowed the GMC's appeal under section 40A of the Medical Act 1983 on three of its four grounds.

Background

Dr Manish Tripathi, a locum GP registered since 2011, faced allegations arising from an August 2023 consultation with Patient A. The tribunal found the allegations proved in their entirety. It concluded that Dr Tripathi had conducted an examination that was not clinically indicated, exposed and touched the patient's breasts without consent or explanation, locked the consultation room door and turned off the light. His conduct, found to be sexually motivated though opportunistic, amounted to sexual harassment within section 26 of the Equality Act 2010 and occurred in the presence of the patient's seven-year-old son.

The tribunal held that Dr Tripathi's fitness to practise was impaired on public protection, public confidence and professional standards grounds. It found his insight limited, a real risk of repetition, and remediation difficult because the misconduct was attitudinal. Despite this, it imposed a ten-month suspension with review rather than the erasure the GMC had sought.

The grounds

The judge upheld the first three grounds. On ground one, the tribunal had quoted and applied a superseded version of the Sanctions Guidance, referring to conduct "fundamentally incompatible" with registration rather than the current test of conduct "difficult to remediate", despite having been addressed on the correct version by counsel for both sides. The change was not merely cosmetic, and the court would not infer that the outcome would have been unaffected. The panel had applied the wrong test.

Ground two concerned the tribunal's omission of paragraph 109(c) of the guidance, which treats serious harm to others as a factor pointing towards erasure. The judge rejected the submission that serious harm was confined to physical injury, noting that psychological harm could readily qualify, and found the tribunal's silence on the point either indicated it had not been considered or reflected inadequate reasoning.

On ground three, the tribunal had assessed only the likelihood of repetition, not its gravity. Applying GMC v Khetyar [2018] EWHC 813 (Admin) and GMC v Konathala [2025] EWHC 1550 (Admin), the judge held that a quantitatively small but real risk of recurrence may be significant depending on the seriousness of the conduct, and the panel had not demonstrated any such analysis.

Relief

The court declined the GMC's invitation to substitute erasure. Ground four, which contended that erasure was the only reasonable outcome, failed. Acknowledging the deference owed to a specialist panel even in sexual misconduct cases, and that he had not heard from Dr Tripathi, the judge held he could not say the tribunal's rejection of erasure fell outside the bounds of what it could properly and reasonably decide.

Notwithstanding the parallels the GMC drew with Konathala, where erasure was ultimately directed, the judge emphasised that each case turns on its own facts. The determination was quashed and the case remitted to a differently constituted tribunal for fresh consideration of sanction.